Covid-19 facility must have provision for psychiatric consultation: Health Ministry – more way of life


The Centre has issued guidelines stating that Covid-19 facilities must have a provision for psychiatric consultation, noting the pandemic has induced mental health concerns, both pre-existing and new onset triggered by way of life restrictions and an uncertain future.

The Union Health Ministry on Sunday issued ‘Guidelines on Managing Mental Illness in Hospital Settings throughout Covid-19’ stating there are no less than three groups affected by mental health concerns throughout the pandemic.

Research suggests that depression (present in approximately 30 per cent of diagnosed patients) and symptoms of post-traumatic stress disorder (nearly everybody diagnosed with Covid-19 –96 per cent) could be extremely high.

Secondly, pre-existent patients with psychiatric disorders may experience a recurrence or worsening of their symptoms throughout the pandemic.

Thirdly, all kinds of psychiatric symptoms, including anxiety (ranging from gentle to severe), worries, non-specific psychological misery, depression, stress symptoms, insomnia, hallucinations, paranoid and suicidal ideation, have been famous throughout the pandemic.

“Moreover, worries related to restriction of lifestyles, issues related to special populations including children and adolescents, job losses and uncertainty approximately the future, increase in domestic violence and child abuse have also been reported.

“Due to this fact, there’s a need for particular guidelines for medical officers and mental health professionals on how to prevent the infection and supply Covid-19-related care in hospital-based settings,” the document stated.

The Covid-19 pandemic has put an inordinate strain on health facilities, and posed unique challenges to mental health care delivery, both locally and institutional and hospital settings, it said.

According to the guidelines, a Covid-19 facility must have a facility for consultation with a psychiatrist either in person or by tele-consultation, while admitting a person with mental illness and at no point must any psychotropic medication be stopped all of a sudden without a psychiatrist’s advice, unless in case of a life-threatening emergency.

“Also, the bed allocated for the patient must be preferably near to the nursing station to verify she or he can also be observed round-the-clock while steps should be taken to make certain that the windows are polite boarded and there is not any access to instruments to harm self/others,” they said.

Information approximately PPE and social distancing can also be given the use of simple language and visual depictions or videos and contact with caregivers must be maintained via video-call facility at set times in the day.

Caregivers should be given day-to-day updates regarding both physical and mental health condition of the patient, the guidelines stated.

The challenges faced by mental health service providers include difficulty in isolating/quarantining patients with active symptoms of mania and acute psychosis in addition to people with mental health emergencies.

Also, patients with psychiatric disorders (by advantage of their symptoms) won’t cooperate throughout swabbing and testing and thus may need to be sedated, and one of the vital procedures and appropriate tests may get delayed.

“Staff needs to be in near contact with one of the vital patients who are at risk of violence or suicidality and to retain a check on them steadily.

“Some patients could also be uncooperative or at times hostile (as an example, those with delusional disorders, psychotic disorders) to the treating team, creating extra challenges to the health providers. Provisions of the Mental Healthcare Act, 2017 need to be complied with-particularly those related to assessment of capacity, supported admission, etc,” the document highlighted.

But even so, homeless persons with mental illnesses are normally brought (including those with highbrow disabilities) to Mental Health Establishments (MHEs). Such patients regularly fail to supply proper history and no dependable informants will be to be had typically. Also the lack of identity proof and legitimate phone number for the Covid testing (a prerequisite as per the ICMR guidelines) are commonly seen in this population, adding to the challenges faced by the mental health service providers, it said.

“Patients and caregivers wish to be encouraged not to visit OPDs of MHEs unless any emergency arises. In case of difficulty in procuring medications in the neighborhood, they are able to contact the native/state/national helpline number services and products for further assistance.

“Services and products like home visits for patients who are unable to visit the OPDs, but require clinical consultation wish to be initiated,” the guidelines said.

The guidelines also stated that MHEs wish to constitute a Hospital Infection Committee which ensures the implementation of the newer norms really helpful by the Health Ministry throughout the pandemic at their establishments, so that you could safely practice mental health services and products.

So far as outpatient facilities are concerned, only appointment-based OPD consultations to prevent crowding must be encouraged.

Moreover, provision for telemedicine/tele-psychiatry services and products shall be utilised for reducing the footfalls further.

The document mentions guidelines for management of Covid-19 in special populations — elderly with mental illness, perinatal women with mental illness, children and adolescents with mental illness, substance use disorder (Alcohol) and substance use disorder (Tobacco).

(This story has been published from a wire agency feed without modifications to the text.)

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